The effectiveness of polymerase chain reaction in testing the removed portion of lung during surgery

<b>Objective:</b> to evaluate the efficiency of MTB detection in tissue samples taken during surgery (TSTDS) using real-time PCR. <b>Materials and Methods:</b> As a diagnostic material the removed portion of lungs of patients with various forms of pulmonary TB from thoracic surgery department were tested. A total of 49 (30 (61%) male and 19 (39%) female) patients were examined. Patient categories: 37 (76%) new cases and 12 (24%) recurrent cases. To compare the efficiencies all pathological materials were examined by microscopy (fluorescence method), as well as molecular - genetic method on GeneXpert MTB / RIF equipment. <b>Results:</b> The results showed high sensitivity and specificity of molecular - genetic method in MTB detection in TSTDS. In 33 out of 49 pathological materials the Xpert MTB / RIF test was positive. Sensitivity to rifampicin anti TB drug was in 18 (55%) cases and resistance in 15 (45%) cases. 18 patients with drug sensitivity were new cases of TB in 12 (67%) of them and recurrent cases in 6 (33%). 15 patients with drug resistance were new cases of TB in 12 (80%) and recurrent cases in 3 (20%) patients. The Xpert MTB / RIF test detected MTB in 12 (36%) patients with negative sputum smears, 4 (33%) of them were resistant forms of MBT. Test error was found in 7 (14%) patients. The average test time on GeneXpert apparatus was two hours per test. <b>Conclusions:</b> Molecular and genetic method based on real-time PCR reduces the detection time of MTB and the <i>rpoB</i> gene mutation in TSTDS, which contributes to the timely correction of treatment regimen of patients. Xpert MTB / RIF test can be used as an initial diagnostic test in analysis of TSTDS in various forms of pulmonary TB.

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